Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

OBJECTIVETo compare quantitatively the enhanced thin CT section with pathologic findings in pulmonary carcinoma, pulmonary inflammatory pseudotumor (IPT) and pulmonary tuberculoma so as to demonstrate the relation of degree of enhancement and the vascular structure within the lesion with special emphasis on pulmonary carcinoma.

METHODSEnhanced thin CT sections were obtained in 35 cases with nodular or patchy lesions in the peripheral lung field which are difficult to differentiate clinically. There were pulmonary carcinoma 21, inflammatory pseudotumor 7 and tuberculoma 7. The number of small vessels (inner diameter 0.02 approximately 0.1 mm), relatively large vessels (inner diameter > 0.1 mm) and their vascular bed areas were analyzed by computed image analyzing system. The relation between CT average attenuation and the number of vessels or the vascular bed areas were statistically evaluated.

RESULTS1. The differences of average attenuation in carcinoma, inflammatory pseudotumor and tuberculoma were statistically significant (P < 0.05). 2. The differences in number of small vessels, relatively large vessels and vascular bed areas among these three types of lesion were also significant (P < 0.05). 3. A positive correlation was found in the average CT affenuation of lung carcinoma and its number of small vessels and relatively large vessels and 4. A positive correlation was found between the average CT attenuation in these three lesions and the relatively large vessels, total vascular amount and vascular bed areas.

CONCLUSIONS1. The average degree of attenuation, being divided into four degrees, is of practical value in the differentiation of lung carcinoma, inflammatory pseudotumor and tuberculoma. 2. The average CT attenuation of lung carcinoma, inflammatory pseudotumor and tuberculoma is in direct proportion to the number of vessels and vessel bed areas and 3. The characteristic CT enhancement in lung carcinoma reflexes the condition of vessels and blood supply within the tumor.

Adult ; Aged ; Female ; Humans ; Lung ; blood supply ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Plasma Cell Granuloma, Pulmonary ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods ; Tuberculoma ; diagnostic imaging ; pathology ; Tuberculosis, Pulmonary ; diagnostic imaging ; pathology

OBJECTIVETo explore the CT features of ground-glass nodules (GGN) including preinvasive lesions [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS)], minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC).

METHODSNinety-seven GGN lesions confirmed by operation pathology were included in this study. The lesions were divided into three groups: preinvasive lesion group (24 cases), MIA group (39 cases), IAC group (34 cases). The lesion size, 3-dimensional ratio, 2-dimensional ratio in axial images, lesion density, shape, speculation, lobulation, air-containing space and pleural indentation on the preoperative CT images in the three groups were analyzed and compared with pathological results. The data were statistically analyzed using SPSS 17.0.

RESULTSAll preinvasive lesions presented as pure GGN on CT image, most showed round-like shape, clear and smooth border. MIA presented as pure GGN or mixed GGN on CT image, most showed round-like shape, with a clear and smooth border. IAC most presented as mixed GGN on CT image, often showed irregular shape. Speculation, lobulation, air-containing space and pleural indentation displayed gradually increasing from preinvasive lesions to MIA and IAC. There were statistically significant differences in lesion size, CT density, shape, air-containing space, speculation, pleural indentation and long diameter of solid component between the MIA and IAC groups (P < 0.05 for all). There were statistically significant differences in CT density values and long diameters of solid component of the lesions between the preinvasive lesion group and MIA group (P < 0.05). The AUC of solid component of the preinvasive lesion group and MIA group was 0.705, and that of the MIA and IAC groups was 0.814.

CONCLUSIONComprehensive analysis of the CT image features of GGNs, especially the solid component in the lesions, may help to the preoperative and differential diagnosis of preinvasive lesions, MIA and IAC.

Adenocarcinoma ; diagnostic imaging ; pathology ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Precancerous Conditions ; diagnostic imaging ; pathology ; Solitary Pulmonary Nodule ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Due to emphasis on early screening for lung cancer, the detection rate of multiple ground glass opacities (GGOs) on computed tomography (CT) image increases in recent years, and research on multifocal adenocarcinomas presented by GGOs has been thriving. It is more common in women and non-smokers and has excellent prognosis both in patients with natural history and after surgery. These clinical features suggest that it is likely to be a distinct disease entity. From the perspective of molecular genetics, lesions in the same individual are likely to have distinct clonal features. Therefore, genetic heterogeneity is the most prominent feature of multifocal pulmonary adenocarcinomas with GGOs. The genetic heterogeneity is expected to assist the diagnosis of multifocal pulmonary adenocarcinoma and intrapulmonary metastasis, and also suggests that genetic testing of the GGO lesions is of great therapeutic significance. Some GGO lesions may harvest the similar clonal feature, which provide new evidence for the theory of spread through air spaces (STAS).
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Adenocarcinoma ; diagnostic imaging ; genetics ; pathology ; Adenocarcinoma of Lung ; Humans ; Lung Neoplasms ; diagnostic imaging ; genetics ; pathology ; Retrospective Studies ; Solitary Pulmonary Nodule ; diagnostic imaging ; genetics ; pathology ; Tomography, X-Ray Computed

Adolescent ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Papilloma ; diagnostic imaging ; pathology ; surgery ; Pneumonectomy ; methods ; Tomography, X-Ray Computed

The International Agency for Research on Cancer (IARC) published the World Health Organization (WHO) classification of thoracic tumors (5th edition) in May 2021, only six years after the 4th edition of WHO Classification. With the application of low-dose spiral computed tomography (CT) as an early screening method for lung tumors in recent years, lung adenocarcinoma has become the main type of disease in many hospital surgical treatments. The WHO classification serves as the authoritative guide for pathological diagnosis, and any slight change in the classification is at the heart of pathologists, clinicians and patients. Adenocarcinoma in situ is a newly added type of adenocarcinoma diagnosis in the 4th edition of the WHO classification, and it is also the focus of clinical treatment and research at home and abroad in recent years. Because its catalog position has been adjusted in the 5th edition of the WHO classification, there has been a huge controversy and discussion among clinicians and patients that "adenocarcinoma in situ was excluded from the category of malignant tumors". This article will briefly explain the origin of the diagnosis of lung adenocarcinoma in situ, the adjustment of the new classification catalog, and whether adenocarcinoma in situ is benign or malignant.
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Adenocarcinoma in Situ/pathology* ; Adenocarcinoma of Lung/diagnostic imaging* ; Humans ; Lung Neoplasms/pathology* ; Neoplasm Staging

Paraganglioma is a rare neuroendocrine tumor arising from the undifferentiated cells of the primitive neural crest. We report a case of malignant paraganglioma originating from the left kidney. The 55-year-old female patient was admitted for intractable cough for a month and the presence of a solid mass in the left lung detected by computer tomography (CT). Sonography revealed a mass in the left kidney after admission. Complete surgical resection of the tumor was performed and the diagnosis of malignant paraganglioma originating from the left kidney was established pathologically. During the follow-up for 12 months, the patient showed a good general condition and sonography revealed no evidence of recurrence. Based on these findings, we discussed the diagnosis of this disease using medical imaging modalities.
Female ; Humans ; Kidney Neoplasms ; diagnostic imaging ; pathology ; surgery ; Lung Neoplasms ; diagnostic imaging ; secondary ; Middle Aged ; Paraganglioma ; pathology ; secondary ; surgery ; Radiography

OBJECTIVETo investigate the diagnostic value of dual-head (18)F-fluorodeoxyglucose ((18)F-FDG) imaging in metastatic lesion with unknown primary tumour (UPT).

METHODSSeventy patients with UPT underwent dual-head (18)F-FDG imaging after iv (18)F-FDG 1.85 MBq/kg. The primary tumour was diagnosed according to the FDG uptake and T/N value.

RESULTSOf the 70 patients, the primary tumour was identified by positive FDG imaging and finally confirmed pathologically in 58 patients (82.9%), and 12 patients had a negative FDG imaging (17.1%). Forty-two of the 58 positive patients were found to have lung cancer (72.4%). Among the 12 negative patients, their primary tumour was then identified by other diagnostic procedures in 5 patients (41.7%), in 1 patient, the primary site was detected during follow-up, however, the primary tumour was never detected in the rest 6 patients.

CONCLUSIONDual-probe (18)F-FDG imaging is a simple, quick, non-invasive and sensitive technique with an accuracy over 80% in the diagnosis of unknown primary tumour. The lung is found to be the most frequent primary site. Dual-probe (18)F-FDG imaging can be recommended as the first diagnostic choice for UPT.

Female ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; Male ; Neoplasms, Unknown Primary ; diagnostic imaging ; pathology ; Positron-Emission Tomography

Breast Neoplasms ; diagnostic imaging ; Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; pathology ; therapy ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; therapy ; Lymphoma ; diagnostic imaging ; Neoplasm Recurrence, Local ; diagnostic imaging ; Neoplasm Staging ; Neoplasm, Residual ; Positron-Emission Tomography ; Treatment Outcome

Humans ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Myelolipoma ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed